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Aged, Blind and Disabled Manual Policy Manual Number: 130.005 Section: CHOICES Chapter: TennCare CHOICES in Long-Term Services and Supports August 01, 2024 Division of TennCare 9 iii. Self-Determination Waiver The Self-Determination Waiver provides community-based services to children and adults with intellectual disabilities and children under age 6 with development delay who would otherwise require the LOC provided in an ICF/IID. To enroll in this wavier program, an individual must: 1. Be a Tennessee resident; 2. Be financially eligible for TennCare Medicaid (Institutional Medicaid or SSI Cash); 3. Meet TennCare Medicaid criteria for payment of institutional ICF/IID care; and 4. Have an adequate support system to assure health and safety while receiving services in a home and community-based setting. 10. Facility Types TennCare Medicaid LTSS payments are available to eligible individuals receiving LTSS in the following medical institutions: a. State Developmental Centers for the Developmentally Disabled, which include: i. Certified Intermediate Care Facility for People with Developmental Disability wards for patients of any age; and ii. Certified Level II nursing wards for patients of any age. Patients in non-certified wards in Level II care are not eligible for TennCare Medicaid, except when transferred to a Title XIX (TennCare Medicaid approved) facility. b. State Mental Health Hospitals and Private Certified Mental Health Hospitals State Mental Health Hospitals and Private Certified Mental Health Hospitals include general hospital wards for patients age 65 and older and certified Level I and Level II wards for patients age 65 and older. Patients in non-certified wards and all patients under age 65 are not eligible for TennCare Medicaid in psychiatric facilities with the following three exceptions: 1. A patient who was already an active TennCare Medicaid recipient when admitted to the psychiatric facility will be eligible the month of admission (no LTSS payment will be authorized). Coverage cannot extend beyond the month of admission, or the earliest month action can be taken to close the case. 2. Ineligible patients who are transferred to a Title XIX facility located off the hospital grounds may attain eligibility during their absence from the facility.